Efficacy and safety of probiotic therapy for halitosis: a systematic review and meta-analysis of randomized controlled trials

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#probiotics #halitosis #humans #randomized-controlled-trials-as-topic #quality-of-life

Efficacy and safety of probiotic therapy for halitosis: a systematic review and meta-analysis of randomized controlled trials

Yang et al., 2025 | J Breath Res | Meta Analysis

Citation

Yang Yichen, Ge Jie, ... Liu Hualian. Efficacy and safety of probiotic therapy for halitosis: a systematic review and meta-analysis of randomized controlled trials. J Breath Res. 2025-Dec-23;20(1). doi:10.1088/1752-7163/ae23f0

Abstract

To evaluate the therapeutic efficacy of probiotics in managing halitosis and to determine the optimal intervention strategies. An extensive search was conducted in PubMed, Web of Science, Cochrane Library, and Embase up to December 2024, focusing on studies evaluating probiotic interventions for halitosis. Sensitivity and subgroup analyses were undertaken to assess the robustness of the results and to explore potential sources of heterogeneity. All analyses were performed through Review Manager 5.4 and STATA 15.0. Of the 194 records initially identified, 10 studies met the predefined criteria. The pooled results demonstrated a significant reduction in volatile sulfur compounds (VSCs) levels in the probiotic group compared to controls (SMD = - 1.01, 95% CI [-1.93, -0.09],P= 0.03). Likewise, the organoleptic test (OLT) scores showed a marked improvement in the probiotic group (RR = 1.31, 95% CI [1.22, 1.41],P< 0.00001). Nevertheless, no substantial differences were observed between groups in oral health-related quality of life (SMD = 0.21, 95% CI [-0.06, 0.49],P= 0.12), subjective oral health status (SMD = - 0.04, 95% CI [-0.35, 0.28],I2= 0%,p= 0.74), depression (SMD = 0.03, 95% CI [-0.29, 0.35],I2= 0%,p= 0.85), self-esteem (SMD = - 0.07, 95% CI [-0.39, 0.25],I2= 0%,p= 0.67), OLT scores (SMD = - 0.24, 95% CI [-0.64, 0.16],I2= 0%,p= 0.24), or plaque index (SMD = - 0.06, 95% CI [-0.57, 0.46],I2= 0%,p= 0.82). The findings suggest that probiotic therapy, when combined with conventional treatments, may be more effective in enhancing OLT scores and reducing VSC levels in individuals with halitosis than using probiotic alone. Nonetheless, potential publication bias, limited sample sizes, and heterogeneity among the included clinical trials may affect the reliability of these conclusions.

Key Findings

Nonetheless, potential publication bias, limited sample sizes, and heterogeneity among the included clinical trials may affect the reliability of these conclusions.

Outcomes Measured

  • depression

Population

Field Value
Population halitosis than using probiotic
Sample Size 10
Age Range See abstract
Condition depression

MeSH Terms

  • Probiotics
  • Halitosis
  • Humans
  • Randomized Controlled Trials as Topic
  • Quality of Life
  • Treatment Outcome
  • Breath Tests

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Systematic Review, Meta-Analysis
  • Vertical: probiotics

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09